Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2022) 81 OC11.4 | DOI: 10.1530/endoabs.81.OC11.4

ECE2022 Oral Communications Oral Communications 11: Thyroid 2 (6 abstracts)

Association of thyroid function and TPO positivity with the risk of postpartum depression: a population-based cohort study and systematic review

Federica Sileo 1,2 , Joris Osinga 3,4 , Edward Visser 3,4 , Arash Derakhshan 3,4 , valeria citterio 1,2 , Luca Persani 1,2 & Tim Korevaar 3,4


1University of Milan, Milan, Italy, Department of Biotechnology and Experimental Medicine, Milan, Italy; 2IRCCS Istituto Auxologico Italiano, Milan, Italy, Lab of Endocrine and Metabolic Research, Department of Endocrine and Metabolic Diseases, Milan, Italy; 3Erasmus Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands, Department of Internal Medicine, Rotterdam, Netherlands; 4Erasmus Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands, Academic Center for Thyroid Diseases, Rotterdam, Netherlands


Background: Postpartum depression (PPD) is a common mental health disorder with a major impact on maternal health and wellbeing and offspring development. Thyroperoxidase antibody (TPOAb) positivity is a major risk factor for postpartum thyroiditis and via this link, it is hypothesized that TPOAb positivity is a risk factor for PPD. However, the results of currently available single center studies are heterogeneous and affected by major study limitations.

Objective: To examine the association of TPOAb and thyroid function with the risk of PPD.

Methods: In the Generation R Study, a population-based prospective birth cohort in Rotterdam, The Netherlands, we measured TSH, FT4 and TPOAb in blood samples collected between 8-18 weeks of pregnancy. Postpartum depressive symptoms were assessed with the Edinburgh Postpartum Depression Scale (EPDS) at 2 months postpartum and with the Brief Symptom Inventory (BSI) at 2, 6 and 36 months postpartum. In addition, we performed a systematic review of literature assessing the association of thyroid function and/or TPOAb positivity with risk of PPD.

Results: There was no association of TSH or FT4 levels with the risk of postpartum depression (log_TSH OR:0.79, 95%CI 0.56-1.13, P=0.20; fT4 OR:1.02, 95%CI 0.96-1.08, P=0.57). There was also no association of TPOAb positivity with PPD (OR:0.79, 95%CI 0.39-1.19, P=0.39). Additional analyses assessed an impaired thyroidal response to hCG stimulation and defined the combined effects of a high hCG with either a high TSH or low FT4 as an alternative marker of TPOAb positivity. We identified that an impaired thyroidal response to hCG stimulation was associated with a lower risk of PPD (P for interaction TSH=0.04 and FT4=0.06). In our systematic review, ten out of 1219 identified articles were included: four studies showed an association of TPOAb positivity with PPD, two showed an association of thyroid function with PPD, the remaining studies showed no association of either thyroid function or autoimmunity with PPD.

Conclusions: Our original study is by far the largest study on this topic showing that neither TPOAb positivity nor TSH or FT4 were associated with PPD. Our systematic review revealed high heterogeneity and suboptimal methodological quality in the current literature, but overall does not support a link with PPD. Although TPOAb positive women should be monitored for postpartum thyroiditis, there does not seem to be an indication to screen for postpartum depression. Further research should focus on other factors potentially involved in the etiology of PPD.

Volume 81

European Congress of Endocrinology 2022

Milan, Italy
21 May 2022 - 24 May 2022

European Society of Endocrinology 

Browse other volumes

Article tools

My recent searches

No recent searches.